Daniel Theodore Boeder

NPI Registration Record

Provider / Organization	NPI	Date Certified
DANIEL THEODORE BOEDER	1669039822	2021-07-12

Daniel Theodore Boeder is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1669039822. Registration indicates Daniel Theodore Boeder is a provider of access to mental health/behavioral health providers services with a specialization in Allopathic & Osteopathic Physicians, Psychiatry & Neurology (Allopathic & Osteopathic Physicians, Psychiatry & Neurology) (Psychiatry & Neurology: Psychiatry, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Psychiatry & Neurology Psychiatry, Allopathic & Osteopathic Physicians) (Psychiatry & Neurology, ) Access to Mental Health/Behavioral Health Providers (Allopathic & Osteopathic Physicians, Psychiatry & Neurology) (Allopathic & Osteopathic Physicians, Psychiatry & Neurology) (Psychiatry & Neurology: Child & Adolescent Psychiatry, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Psychiatry & Neurology Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians) (Psychiatry & Neurology, )

Registration	PART-B:Y DME:Y HHA:Y PMD:Y
Entity Type	Individual
Provider Name	Dr. Daniel Theodore Boeder
Practice Office Address	319 E MADISON ST FL 3 SPRINGFIELD, IL US
Practice Office Telephone	2175456900
Practice Office Fax	2175856893
Mailing Address	PO BOX 19642 SPRINGFIELD, IL 627949642 US
Business Telephone	2176568229
Business Fax	2175856893

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